The present invention relates to a method for treating diseases which affect the supporting tissues of the teeth, and particularly to a method for treating periodontitis.
Benzo-c-phenanthridine alkaloids can be extracted from plants of the families Papaveracease, Fumariaceae, and Berberidaceae. Some of the plants of these families include Sanguinaria canadensis, Macleaya cordata, Bocconia frutescens, Carydalis sevctcozii, C. ledebouni, Argemone mexicanus, and Chelidonium majus. Among the most important benzo-c-phenanthridine alkaloids obtained from these plants are sanguinarine, chelirubine, macarpine, allocryptopine, protopine, hemochelidonene, sanguilatine, sanguirubine, and chelerythrine.
The best known of these alkaloids is sanguinarine, which has previously been extracted from the Sanguinaria canadensis plant, otherwise known as bloodroot, teterwort, redroot, puccoon, etc., a perennial herb native to North America. The Sanguinaria plant and its juices have been used for various purposes in pre-historic and historic times. The plants has been used, in particular, as a folk remedy. The plant had generally been used whole, either undried (fresh) or dried. The usual procedure is to powder the dried plant and mix it with a carrier. This folk remedy has been tried for such condition as asthma, bronchitis, dysentery, ringworm, and a substantial list of other ailments.
The pure chemicals sanguinarine, chelerythrine, protopine, chelerubine, berberine, chelilutine, sanguilatine, macarpine, sanguirubine, and allocryptopine can be isolated from plants other than Sanguinaria. They are also available, although rarely, from some chemical supply houses. Semi-purified forms of the alkaloids are commercially available, and these are generally referred to as sanguinarine nitrate and sanguinarine sulfate. These "salts" are the salts of the mixed alkaloids of the plant Sanguinaria: mainly sanguinarine, chelerythrine, and protopine. While few references can be found in the literature regarding the usage of any of the pure benzophenanthridine alkaloids, plants containing such compounds have been used for a wide variety of medical ailments.
The alkaloid sanguinarine in solution has been shown to have some antifungal and antiprotozoan properties. The sanguinarine is applied as an emulsion topically to fungal infections. The antibacterial activity of sanguinarine has been found to vary with that attached radicals, and various salts of sanguinarine have been shown to have some activity. The hydrochloride and the sulfate salts have been found to have some activity against certain bacteria at certain concentrations. Sanguinarine nitrate is reposted to have some bacteriostatic action against various types of bacteria.
An early patent, U.S. Pat. No. 209,331, discloses the use of bloodroot, zinc chloride, and kerosene oil in equal proportions for treating open sores. U.S. Pat. No. 433,257 describes a salve of pulverized bloodroot, armenian bole, powdered rosin, lard, and Stockholm tar for use in the treatment of piles. U.S. Pat. No. 2,344,830, discloses the use of a mixture of zinc chloride, stibnite, and bloodroot to fix and outline diseased tissue for excision by surgery.
Several more recent patents have disclosed the use of extracts of Sanguinaria for treating the oral cavity for conditioning oral tissue as well as in preventing and treating gingivitis, periodontitis, and mouth odors. Some of the patents describing the use of Sanguinaria extracts as antimicrobial agents as well as mouth treating agents are U.S. Pat. No. 4,145,412; U.S. Pat. No. 4,406,881; U.K. Pat. No. 2,042,336; U.S. Pat. No. 4,376,115; German Offen. No. 2,907,406; Belgian No. 888,843. The use of sanguinarine with thiophosphoric acid in various animal and human neoplasms is shown in French Pat. Nos. 70-22029 and 2,159,972.
In the past, the active ingredients were extracted from the plant material by extracting the comminuted plant material with methanol, filtering the liquid extract obtained, evaporating the extract to dryness, dissolving the dried residue in chloroform, acidifying the chloroform extract, filtering the acidified extract, evaporating it to dryness, and dissolving the dried residue in glycerine for mixing with a carrier.
Periodontitis, or pyorrhea, is a disease affecting the supporting tissues of the teeth including the gingiva, the membrane lining the sockets in which the teeth lie, and the bones surrounding the teeth. The disease may initially be associated with conditions of constant irritation of the gingiva by dental calculus, food impaction, poor dental restoration, traumatic occlusion, or chemical irritants.
When normal, the gums are pink and resilient, and heal promptly when injured. The gums, however, may be seriously harmed by deposits of dental calculus (tartar), a combination of mineral and bacteria found in the mouth. The bacteria associated with tartar can secrete enzymes and endotoxins which can irritate the gums and cause inflammatory gingivitis. As the gums become increasingly irritated by this process they have a tendency to bleed, lose their toughness and resiliency, and separate from the teeth, leaving periodontal pockets in which debris, secretions, more bacteria, and toxins further accumulate. It is also possible for food to accumulate in these pockets, thereby providing nourishment for increased growth of bacteria and procuction of endotoxins and destructive enzymes. The pus that forms in the process is capable of destroying gum and bone tissue. A variety of bacteria are generally found to be present during the active stages of periodontal disease. Such organisms as streptococci, staphylococci, pneumococci, and the like, are usually present, and are found in the purulent discharge as well as in the involved tissue, and may be absorbed into the general system through the lymphatics or venous blood stream.
The progression of the pyorrhetic process usually begins with gingivitis, initiating at the margins of the gums, in which the gingiva become more tender and sensitive, and appear flabby, inflamed, and swollen. Periodontal pockets become apparent, and infection takes place in these pockets. Because the periodontal pockets cannot be cleaned by brushing or the use of dental floss, infection becomes progressive and constant. A purulent or toxic discharge is common from the affected tissues, with which may be associated an abnormal taste and odor in the mouth.
The periodontal disease may gradually involve the deeper periodontal tissues until all the supporting tissues of the teeth, including bone, are affected. When the pyorrheic process has proceeded to the stage of destruction of the periodontal tissues, the teeth become loosened, and are usually lost in the most advanced stages of the disease. An additional adverse effect on the general well being of the affected individual is the potential for absorption of a considerable amount of toxic prurulent or bacterial matter into the general circulation.
Although pyorrhea is generally considered curable in the early stages, when treated by a dentist, the most effective coventional treatment has been preventive, involving strict oral hygiene and periodic dental prophylaxis. Methods of treatment of persons who are already affected by the disease include regular calculus removal by the dentist, grinding off rough dental surfaces, surgical removal of diseased gingival tissue, and opening and trimming of periodontal gingival pockets.
However, conventional methods of treatment are not entirely satisfactory, and periodontitis continues to be a principal dental disease and a major case of the loss of teeth. A relatively simple method for treating periodontitis which would be effective in controlling the disease would be very desirable. In addition, such a method which could be employed by individual patients in self medication on a regular basis would be most desirable.